Richard Goy

Prevention of Weight loss in dementia with comprehensive nutritional treatment

OBJECTIVES: To determine whether body weight can be maintained or improved in dementia residents of special care units (SCUs) using a comprehensive intervention strategy.

Lowering body mass index cutoffs better identifies obese persons with spinal cord injury.

Study design:Cross-sectional, non-experimental design.Objectives:(1) Determine the sensitivity and specificity of the general population body mass index (BMI) cutoff for obesity (30 kg m−2) in a representative sample of persons with spinal cord injury (SCI); (2) develop a more sensitive BMI cutoff for obesity based on percentage of fat mass (%FM) and C-reactive protein (CRP).Setting:Ontario, Canada.Methods:A total of 77 community-dwelling adults with chronic SCI underwent anthropometric measures (%FM by bioelectrical impedance analysis, length, weight, BMI (kg m−2)) and provided blood samples to determine CRP. Sensitivity and specificity analyses, piecewise regression, non-linear regression, and receiver–operator characteristic curves were used to determine new BMI cutoffs.Results:A BMI cutoff of 30 kg m−2 failed to identify 73.9% of obese participants vs 26.1% at a lowered cutoff of 25 kg m−2. BMI cutoffs based on risk levels of the %FM and CRP considered together ranged from 22.1 kg m−2–26.5 kg m−2.Conclusions:People with chronic SCI and BMI values >22 kg m−2 should be considered as being at high risk for obesity and obesity-related chronic diseases.Sponsorship:Canadian Institutes of Health Research.

Zinc-Fortified Foods Do Not Improve Intake of Total Dietary Zinc for Ontario Preschoolers

Objective: To examine if zinc food fortification makes a significant contribution to dietary zinc intake and to describe zinc-fortified food usage, amongst Canadian preschoolers. Methods: Cross-sectional data were used from the NutriSTEP™ validation project for which preschoolers (3–5 years) from across Ontario were recruited using convenience sampling. Three-day food records were used to estimate mean daily zinc intake and children were stratified by age group for analysis. Comparisons were then made to the Dietary Reference Intakes, whilst accounting for zinc from zinc-fortified foods and supplements and also whilst excluding zinc from zinc-fortified foods, to determine the prevalence of inadequate (< Estimated AverageRequirement (EAR)) and excessive (> Tolerable Upper Intake Level (TUL)) zinc intakes. The contributions (%) made to total zinc intake by zinc-fortified foods, unfortified foods and zinc-containing supplements were determined as were contributions made to zinc intake by zinc-fortified foods, categorized by fortified-food type. Results: Fewer than a third (30%, n = 76) of participants ate zinc-fortified foods and only 3% (n = 7) used a zinc-containing supplement. Including the contribution from zinc-fortified foods, 25% (n = 32) of 3-year-olds (n = 128) had mean zinc intake (range 7.0–7.6 mg/day) marginally above the TUL (7 mg/day). Zinc-fortified foods contributed only 2.3 ± 5.8% (mean% ± SD) to total zinc intake. The mean intake of the 25% of 3-year-olds above the TUL is attributed to their higher mean energy and protein intakes (p < 0.001) as compared to 3-year-olds not consuming zinc at levels above the TUL. Even excluding zinc-fortified foods, the prevalence of inadequate zinc intakes (<EAR) (n = 254) was zero. Fortified breakfast cereals contributed most (77 ± 41%) (mean% ± SD) to zinc intake derived from zinc-fortified foods. Conclusions: Overall, zinc-fortified foods and supplements contributed minimally to the total dietary zinc intake amongst these preschoolers. These children did not have inadequate intakes of zinc and intakes in excess of the TUL were only evident in the youngest age group. Food fortification and parental choice to use a multivitamin-mineral supplement did not appear to play a role in either preventing inadequate or causing excessive zinc intake.

Leisure-time physical activity and diet quality are not associated in people with chronic spinal cord injury

Study design:Cross-sectional.Objective:To determine the association between leisure-time physical activity (LTPA) and adherence to Eating Well with Canadas Food Guide (CFG) in community-dwelling adults with chronic Spinal Cord Injury (SCI).Setting:Ontario, Canada.Methods:Participants were recruited as part of the Study of Health and Activity in People with SCI (SHAPE-SCI). Dietary data were collected using 24-h recalls and analysed for adherence to CFG recommendations by age group and gender. LTPA was assessed using the Physical Activity Recall Assessment for Persons with SCI. Statistical analysis comprised correlations, multiple regression and χ 2.Results:We studied 75 adults (n=61 M; 42.4±11.8 years; 25.5±5.2 kg m–2) with chronic (⩾1-year post-injury) SCI. Of these, 37% of participants were inactive, 29% were low-active and 33% were high-active. Fewer than 5% of participants were 100% adherent with CFG; 85% were adherent to ⩽50%. Activity level and overall adherence to CFG were not correlated (r=−0.052, P=0.666). Although there were no associations between LTPA and vegetables and fruit, grain products, milk and alternatives, or other foods (all P>0.05), high activity was associated with consuming less than the minimum number of recommended servings of meat and alternatives (φ=−0.258, P=0.026).Conclusion:Clinicians need to be aware of the poor diet quality, and low levels of physical activity, of people with chronic SCI. They should not assume that those who are more active consume better quality diets than those who are low active or inactive.Sponsorship:Canadian Institutes of Health Research.

Folic acid food fortification prevents inadequate folate intake among preschoolers from Ontario

OBJECTIVE Folic acid food fortification has successfully reduced neural tube defect-affected pregnancies across Canada. The effect of this uncontrolled public health intervention on folate intake among Canadian children is, however, unknown. Our objectives were to determine folic acid intake from food fortification and whether fortification promoted adequate folate intakes, and to describe folic acid-fortified food usage among Ontario preschoolers. DESIGN Cross-sectional data were used from the NutriSTEP validation project with preschoolers recruited using convenience sampling. Mean daily total folate and folic acid intakes were estimated from 3 d food records, which included multivitamin supplement use. Comparisons were made to Dietary Reference Intakes, accounting for and excluding fortificant folic acid, to determine the prevalence of inadequate and excessive intakes. SETTING Canada. SUBJECTS Two hundred and fifty-four preschoolers (aged 3-5 years). RESULTS All participants (130 girls, 124 boys) ate folic acid-fortified foods and 30% (n 76) used folic acid-containing supplements. Mean (SE) fortificant folic acid intake was 83 (2) microg/d, which contributed 30% and 50% to total folate intake for supplement users and non-users, respectively. The prevalence of total folate intakes below the Estimated Average Requirement was <1%; however, excluding fortificant folic acid, the prevalence was 32%, 54% and 47% for 3-, 4- and 5-year-olds, respectively. The overall prevalence of folic acid (fortificant and supplemental) intakes above the Tolerable Upper Intake Level was 2% (7% among supplement users). CONCLUSIONS Folic acid food fortification promotes dietary folate adequacy and did not appear to result in excessive folic acid intake unless folic acid-containing supplements were consumed.

Eliciting provider and patient perspectives to develop an interdisciplinary obesity management planning framework in primary care

D. Royall, P. Brauer, E. Ackah, J.J.M. Dwyer, A.M. Edwards, R. Goy, T. Hussey, and N. Kates Nutrition Research Consulting, Fergus, Ontario, Canada; Department of Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada; Research Consultant, Guelph, Ontario, Canada; Department of Computing and Communications Services, University of Guelph, Guelph, Ontario, Canada; Hamilton Family Health Team, Hamilton, Ontario, Canada